From the Guidelines
Alcohol withdrawal symptoms can last for several weeks to months, with the acute withdrawal phase typically peaking within 24-72 hours and gradually improving over 5-7 days, but post-acute withdrawal syndrome (PAWS) can persist for up to a year in severe cases. The duration of alcohol withdrawal symptoms varies based on factors including drinking history, overall health, age, and whether medical treatment is received 1.
Factors Influencing Duration
- Drinking history: Heavy, long-term drinkers are more likely to experience prolonged withdrawal symptoms
- Overall health: Presence of comorbidities, such as liver disease, can affect the duration and severity of withdrawal symptoms
- Age: Older individuals may be more susceptible to prolonged withdrawal symptoms
- Medical treatment: Receipt of medical treatment, including benzodiazepines and nutritional supplements, can impact the duration and severity of withdrawal symptoms
Management of Alcohol Withdrawal
- Benzodiazepines, such as diazepam or lorazepam, are commonly prescribed to manage severe withdrawal symptoms and prevent complications like seizures or delirium tremens 1
- Nutritional supplements, including thiamine, are important during recovery to prevent Wernicke's encephalopathy 1
- Medical supervision is essential during alcohol withdrawal, especially for heavy drinkers, as severe withdrawal can be life-threatening 1
Monitoring and Treatment Adjustment
- Regular monitoring is necessary to guide dosage adjustment and prevent seizures 1
- Treatment should be personalized and symptom-adapted, with short-acting drugs preferred in patients with decompensated liver disease 1
From the Research
Duration of Longest Alcohol Withdrawal Symptoms
- The duration of alcohol withdrawal symptoms can vary, with some symptoms persisting for several weeks, months, or even years after drinking cessation 2.
- One study reported a case of a patient with a prolonged and severe form of alcohol withdrawal delirium, who received approximately 100 mg diazepam per week to manage symptoms, even 11 weeks after admission 3.
- Protracted alcohol withdrawal (PAW) presents some symptoms that may persist for several weeks, months, or even years after drinking cessation, including craving, sleep disorders, and anhedonia 2.
- A systematic review found that pooled Obsessive Compulsive Drinking Scale (OCDS) scores decreased from 24.2 at baseline to 18.8 at 1 week, 10.3 at 1 month, and 9.7 at 3 months, indicating a gradual reduction in symptoms over time 2.
- The pharmacological approach to managing PAW may ensure a more rapid reduction of symptoms, achieving in three weeks similar results obtained only after almost 6 months without treatment 2.